- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $953.92 / $7,920.26 / $18,711.00
| Facility | | $953.92 | $7,920.26 | $18,711.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,018.34 / $7,547.82 / $15,403.47
| Facility | | $1,018.34 | $7,547.82 | $15,403.47 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $388.48 / $646.16 / $646.16
| Facility | AS | $388.48 | $646.16 | $646.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $714.97 / $870.49 / $2,846.84
| Facility | | $714.97 | $870.49 | $2,846.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $808.86 / $1,596.18 / $2,514.94
| Facility | | $808.86 | $1,596.18 | $2,514.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,064.77 / $1,454.57 / $1,532.29
| Facility | | $1,064.77 | $1,454.57 | $1,532.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $738.78 / $1,018.34 / $2,218.36
| Facility | | $738.78 | $1,018.34 | $2,218.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,221.67 / $8,047.87 / $15,403.47
| Facility | | $5,221.67 | $8,047.87 | $15,403.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,547.00 / $2,408.00 / $10,522.00
| Facility | | $1,547.00 | $2,408.00 | $10,522.00 |